The NHS: Getting Behind the Political Rhetoric to the Facts

The NHS was founded in 1948, and ever since it has been a cornerstone of British society. Whilst the idea was a noble and ambitious one, by 1952 expenditure was exceeding expectations and this lead to the one shilling charge for prescriptions, precipitating the resignation of Aneurin Bevan who was the Minister for Health when the NHS was founded. Clearly, then, funding has been an issue from its inception right through to the present day, and the following article will get around the political discourse and explain the facts.

Funding is at the heart of the NHS, and whenever it comes up in parliament the procedure is generally whoever is in opposition accusing the Government of not funding the NHS enough and the Government announcing funding to one area whilst taking it from another. The most recent example of this was the announcement of an extra £10billion funding over five years to NHS England. Despite this, once you dig a little deeper other areas such as social care have had their funding cut by around £4.5billion. This means in real terms the Department of Health have only about £5billion to spend over the five-year period. It is predicted that there will be a £30billion funding gap by 2020, and so the rest of the money must be found in savings. This article will outline a few areas in which money may be able to be saved within the NHS.

Back in June 2016, the Times published an article exposing the extortionate rise in the cost of so called generic drugs. These are drugs that are identical to a named drug and can be sold and bought at significantly lower prices than the branded equivalent. However, over the last five years, 32 generic drugs have undergone price increases of 1000% or over. One specific example, hydrocortisone, has increased in price from £0.70 to £85, an increase of over 12,000%. You would expect the NHS, as a mammoth sized buyer, to be able to drive a hard bargain on the open market and get a good deal. Interestingly though, the Times’ conclusion was that the fault lay at the feet of a small group of entrepreneurs driving up the prices, instead of the NHS not bargaining for a decent price. Whatever your viewpoint, the increase in prices it is costing the NHS and extra £262million a year; the equivalent of hiring 7,000 junior doctors on £37,000 a year.

In essence, the setup of the NHS means it is always going to be a sink hole for money. This in itself isn’t a problem, and although a more efficient NHS means people are seen to faster and returned to work more promptly, one still needs a strong and functioning economy to be able to support investment into the service. However, the NHS itself could improve efficiency within its service. New systems to decrease bureaucracy need to be implemented on a hospital to hospital basis; trying to implement a nationwide scheme would see it lost in a system as vast as the NHS. An audit by the Health and Social Care Information Centre (2014) concluded that the use of automated technology could increase productivity and decrease delays by reducing the time needed to complete clerical tasks such as patient records and admittance forms. However, the new systems weren’t being used effectively and so were actually increasing bureaucracy by introducing an extra thing to complete along with paperwork. One of the biggest problems highlighted was duplication of data along the patient journey and the mismatches in information that arise thus. It is observed in the report that although checking the data verbally is a good idea to make sure the right care is provided, filling out the same details on different forms is clearly burdensome. In short, coming up with new ways to streamline admittance without losing accuracy, maybe in the form of integrated digital patient records, may be crucial in order to help maintain patient care within the NHS.

It is clear that key causes for the increase in money needed to fund the NHS are an aging population, increases in cancer diagnoses and new and advanced technology to help treat patients. Diabetes however, costs around £8.8billion a year, the vast majority of which is type 2, from a total budget of £98billion, and is only predicted to increase given the projections of obesity levels in the UK. Surely then, this cost can be largely eliminated by decreasing sugar intake and increasing fitness and wellbeing as a society. This is an ambitious idea, but given that we all benefit from the continuation of the NHS, arguably we all need to take a bit of responsibility to eat better, drink less and do more exercise as a nation so that the NHS can endure. A combination of locally funded projects and support from Westminster along with a collective responsibility to be healthier would go some way to solving the NHS funding crisis.

In summary, there are no concrete answers to the frankly huge problem of funding the NHS in the short or long term, but there are certainly a number of possible options to save money within the service. Clearly, this isn’t an excuse for failure to fund the NHS properly, but potentially saving costs in running the NHS in the aforementioned ways is certainly a good thing. Whatever happens though, the NHS will undoubtedly remain a crucial political topic of debate for decades to come.